Provider Demographics
NPI:1053893040
Name:ALFONSO LEYVA, HANSEL
Entity type:Individual
Prefix:
First Name:HANSEL
Middle Name:
Last Name:ALFONSO LEYVA
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11750 SW 18TH ST APT 422
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33175-1633
Mailing Address - Country:US
Mailing Address - Phone:786-366-3316
Mailing Address - Fax:
Practice Address - Street 1:6155 SW 130TH AVE APT 1405
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33183-5233
Practice Address - Country:US
Practice Address - Phone:786-366-3316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-05
Last Update Date:2025-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician